Jackson had surgery today to place the VP shunt to drain the excess fluid in his head. The surgery was successful with an easy recovery today. His head is sore on his right side where the shunt runs from the top of his head down to his abdomen. The doctor specified with an adjustable valve how much fluid to drain. The valve turns with a magnetic key. Jackson also had a spinal tap done today while he was under anesthesia to determine whether or not he has cancer cells in his spinal fluid. This will help us to decide what his course of treatment will be. Jackson's oncologist spoke with me today about a "tumor board" that he is on with many other pediatric oncologists in California. He wanted to present Jack's case to the board to get feedback from other oncologists. Jackson's tumor is unique because typical medulloblastomas are not very vascular. Jack's is very vascular, that is why they were not able to remove all of it. The decision lies between a more aggressive radiation treatment first, then chemo or chemo first, then surgery to remove the rest of the tumor then radiation and chemo again. Aggressive radiation could leave Jackson with some delays developmentally but would most likely kill the cancer. Chemo and then surgery is not for sure because chemo is not as aggressive with the tumor but could shrink the blood supply making surgery possible. In the time it takes to do the chemo, the cancer could possibly spread so Jack could end up with the higher doses of radiation after all. There seem to be alot of "ifs" in both courses of treatment. Not all children have serious delays with the radiation, so I guess we have to weigh all risks and benefits. As you can imagine this is not easy for us, but we do have time to decide. We do have the option of doing his treatments in Santa Barbara at Cottage Hospital. There is a pediatric oncologist there that can do the radiation and chemo just as they can at any of our other options. In that case we could be home every night.

Warren and I came up to see him this evening after dinner and Jackson let me trim his nails and brush his teeth. He was quite playful for a medicated child. He was laughing and karate chopping Warren with his frail arm. We talked of bringing up the Nerf guns so that we could shoot the nurses. He laughed about that but then he was tired again. Oh well, there is always tomorrow!

Jenise